| NPI | 1639606213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 4906) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 0004906) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-07-21 |