| NPI | 1710497722 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 005170) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| 207Q00000X Family Medicine (Licence: CO 005170) | |
| Enumeration Date | 2017-10-04 | 
| Last Update Date | 2025-03-20 |