| NPI | 1982117115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007879) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0100-005990) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2023-08-16 |