| NPI | 1043703523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08162) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0008647) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2024-09-13 |