| NPI | 1811467624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008445) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4327) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008445) | |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2024-11-11 |