| NPI | 1710371604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004916) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52317) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2023-09-12 |