| NPI | 1265049860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006450) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2021-01-13 |