| NPI | 1639574924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004663) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1864) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2016-08-01 |