| NPI | 1760036107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005865) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CO PA.0005865) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2019-08-14 |