| NPI | 1720171267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005224) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004022) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-03-08 |