| NPI | 1245966704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008363) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 13077924-1206) |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2024-10-25 |