| NPI | 1750119913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.8985) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2025-02-25 |