| NPI | 1003095845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005129) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012165) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2023-08-21 |