| NPI | 1760928204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007778) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058684) |
| Enumeration Date | 2017-01-08 |
| Last Update Date | 2023-04-26 |