| NPI | 1407038631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004391) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1349) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2016-11-30 |