| NPI | 1730740093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007358) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1182) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2023-01-04 |