| NPI | 1386832608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003708) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA AP2422) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2021-09-01 |