| NPI | 1972840536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007575) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5954) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2022-12-09 |