| NPI | 1508268368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004186) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 081355) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2022-10-26 |