| NPI | 1861886780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 6015) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA5311) |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2019-11-26 |