| NPI | 1124072616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007372) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WY 058) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2023-04-14 |