| NPI | 1255906061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA203520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006586) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2022-04-20 |