| NPI | 1477799310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 1038) |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2020-01-20 |