| NPI | 1790811065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005093) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA16195) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2021-08-31 |