| NPI | 1518368885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005015) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 1121024) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2021-08-18 |