| NPI | 1225678394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 6212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7756) |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2021-10-11 |