| NPI | 1679990451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004993) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004536) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2023-11-17 |