| NPI | 1568816882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004612) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2024-0024) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2024-03-21 |