| NPI | 1366918427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO PA.0005404) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 8871) |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2023-10-03 |