| NPI | 1811403363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005295) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO PA.0005295) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2024-02-15 |