| NPI | 1417385428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO PA.0004447) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NE 1759) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2024-03-19 |