| NPI | 1215562517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 322254) |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2025-06-09 |