| NPI | 1285831974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA3404) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA pa19198) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003404) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-07-27 |