| NPI | 1295031714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0003838) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NM PA2010-0079) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2016-12-29 |