| NPI | 1972977890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4634) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 300532) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2021-03-17 |