| NPI | 1386346211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.9179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7405-023) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2026-02-02 |