| NPI | 1255746095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA0004264) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 3326-23) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2017-06-15 |