| NPI | 1427550300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005209) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY PA750) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2022-09-29 |