| NPI | 1497129720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.00045459) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108847) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2022-07-21 |