| NPI | 1588068811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005136) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5863) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2021-09-22 |