| NPI | 1376979211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004414) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004414) |
| 363A00000X Physician Assistant (Licence: CA PA23263) | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2018-10-19 |