| NPI | 1497322838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115666) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006917) |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2024-08-09 |