| NPI | 1912320920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003933) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2016-05-04 |