| NPI | 1245208677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0002793) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM 2001-PA10) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2017-10-19 |