| NPI | 1700269453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005773) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0978) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2019-07-24 |