| NPI | 1871103531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006490) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1173623) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2022-04-18 |