| NPI | 1366917031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 6400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7565) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2021-12-03 |