| NPI | 1275782765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0002656) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2656) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2020-06-23 |