| NPI | 1952414872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003975) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3975) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 3477) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2019-08-16 |