| NPI | 1659599975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO PA.0004453) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO PA.0004453) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2017-04-04 |