| NPI | 1548844624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA0006834) |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2025-01-29 |