| NPI | 1710298260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA0003017) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3017) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO 3017) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2021-06-22 |