| NPI | 1902922529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 377) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 377) |
| 363A00000X Physician Assistant (Licence: OR PA01203) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2014-05-02 |