| NPI | 1245635127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004695) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO PA.0004695) |
| 363AS0400X Physician Assistant Surgical (Licence: CO PA.0004695) | |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2022-03-02 |