| NPI | 1811285307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO PA.0003915) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21630) |
| 363A00000X Physician Assistant (Licence: CO PA0003915) | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2020-03-05 |