| NPI | 1053938233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO MSPA.0000015) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 11931704-1206) |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2024-04-10 |