| NPI | 1205403334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO PA.0006826) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-09-30 |