| NPI | 1932184264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051081) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2016-10-07 |