| NPI | 1740764133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007833) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2021002165) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2023-03-20 |