| NPI | 1710497722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 005170) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 005170) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2020-01-13 |