| NPI | 1063960490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2930) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004741) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2025-10-16 |