| NPI | 1033605704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007018) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002467A) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2022-02-24 |