| NPI | 1669598470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 2734) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 2270) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2009-03-11 |