| NPI | 1326779943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0009090) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.010147) |
| 363A00000X Physician Assistant (Licence: WI 7780-23) | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-08-05 |