| NPI | 1124513981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 6557) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55696) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2021-09-01 |