| NPI | 1588112528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004864) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 2074) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2019-01-16 |