| NPI | 1669040044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007134) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007134) | |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2022-05-10 |