| NPI | 1720621964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.005975) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 00005975) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2023-05-11 |