| NPI | 1235199811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA-3274) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1759-023) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2023-02-15 |