| NPI | 1255661013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006040) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013690) |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2021-12-16 |