| NPI | 1578548863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004253) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: 1058069) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2021-05-11 |