| NPI | 1356394241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA0003731) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2013-0028) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2022-04-20 |