| NPI | 1053737494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006726) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017423) |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2023-06-09 |