| NPI | 1962827717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004698) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 2568) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2016-07-20 |