| NPI | 1306299169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0007025) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007025) | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2023-01-17 |