| NPI | 1811127319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2441) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2015-12-16 |