| NPI | 1104549476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008247) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064008) |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2024-05-05 |