| NPI | 1538193867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003441) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS PA047) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2014-09-04 |