| NPI | 1295921716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 1553) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 132595) |
| 363A00000X Physician Assistant (Licence: UT 14222468-1206) | |
| 363A00000X Physician Assistant (Licence: CO 1553) | |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2025-07-30 |