| NPI | 1669779120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO pa.0003637) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 006058) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2016-08-11 |