| NPI | 1336796804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008585) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112346) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2024-06-26 |