| NPI | 1003355306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005731) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020647) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2025-03-13 |