| NPI | 1285391821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 1192657) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007121) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2022-01-17 |