| NPI | 1639329568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0006939) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5422) |
| Enumeration Date | 2008-09-28 |
| Last Update Date | 2023-01-05 |