| NPI | 1205110756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006273) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA200483) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2021-01-30 |