| NPI | 1356007322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008218) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-1072) |
| Enumeration Date | 2021-11-13 |
| Last Update Date | 2024-01-24 |