| NPI | 1356393763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005394) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM 99-PA27) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-06-07 |