| NPI | 1396468054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11105) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0007570) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2025-05-13 |