| NPI | 1750094652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007728) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1196182) |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-02-14 |