| NPI | 1902483126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006823) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 0006823) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2022-11-18 |