| NPI | 1134906639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0008284) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-12-07 |