| NPI | 1417231333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3907) |
| 363A00000X Physician Assistant (Licence: MN 11203) | |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2018-10-19 |