| NPI | 1972135408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008861) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008861) |
| 106S00000X Behavior Technician (Licence: AR 20-112149) | |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2024-12-03 |