| NPI | 1851859276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006702) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7511) |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2024-05-11 |