| NPI | 1841365780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006211) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA LA#A10389) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-09-11 |