| NPI | 1073175667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008419) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 1179188) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2024-04-10 |