| NPI | 1528490976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004218) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 2948) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2015-08-04 |