| NPI | 1205813656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007776) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 6702) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2023-10-27 |