| NPI | 1902564388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO PA.0007154) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2025-04-28 |