| NPI | 1356805626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006099) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006099) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2021-08-12 |