| NPI | 1528493368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0004631) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004318) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2019-05-08 |