| NPI | 1912921487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004936) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 3643) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-07-05 |