| NPI | 1205385309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO PA.0004830) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004830) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2021-08-14 |