| NPI | 1982620498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA1591) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 1591) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2011-02-16 |