| NPI | 1164969648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA0006272) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WY 985) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2024-06-12 |