| NPI | 1740672583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007545) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200796) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2022-11-04 |