| NPI | 1417340324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004814) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1897) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2023-06-08 |