| NPI | 1083360184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007909) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1191532) |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2024-03-12 |