| NPI | 1538447081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004620) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6182) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2020-02-14 |