| NPI | 1336496611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3417) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003417) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2020-07-24 |