| NPI | 1649665209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006590) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005746) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-10-29 |