| NPI | 1710303292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007137) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04842) |
| Enumeration Date | 2014-03-08 |
| Last Update Date | 2022-01-25 |