| NPI | 1558751354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005465) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108499) |
| Enumeration Date | 2015-01-31 |
| Last Update Date | 2019-11-22 |