| NPI | 1871047753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO PA.0004945) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NM PA2016-0060) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2018-06-21 |