| NPI | 1811239684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004242) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4662) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2021-02-16 |