| NPI | 1225579543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004942) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO PA.0004942) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-01-09 |