| NPI | 1235200809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA617) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 617) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA00617) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2023-03-07 |