| NPI | 1053944769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008528) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.006370RX) |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2024-07-01 |