| NPI | 1770032781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006977) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0001772) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2021-10-15 |