| NPI | 1255908018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2021006398) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0009622) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2026-04-24 |