| NPI | 1568559250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 0003286) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003286) |
| 363AM0700X Physician Assistant, Medical (Licence: IA 001724) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2018-04-06 |