| NPI | 1871951194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0004770) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53218) |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2020-06-03 |