| NPI | 1275878324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003603) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA 3603) |
| 363AM0700X Physician Assistant, Medical (Licence: CO 3603) | |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2023-11-30 |