| NPI | 1982702239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003956) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 2544) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-11-24 |