| NPI | 1487112876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1433) |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2022-02-28 |