| NPI | 1912199019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007726) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104196) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2023-03-08 |