| NPI | 1376196550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA0008995) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WA 61005182) |
| 363A00000X Physician Assistant (Licence: WA PA61608960) | |
| 363A00000X Physician Assistant (Licence: CO PA0008995) | |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2025-03-03 |