| NPI | 1811447451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005909) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058586) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA MA058586) | |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2019-08-06 |