| NPI | 1790352037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006875) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006875) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2022-11-18 |