| NPI | 1134672371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 11544898-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004688) |
| Enumeration Date | 2016-07-24 |
| Last Update Date | 2024-06-25 |