| NPI | 1902234107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0003824) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5541) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2021-04-13 |