| NPI | 1497171557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0004773) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2014-0005) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2021-07-22 |