| NPI | 1710561055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0009068) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11525) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2025-10-14 |