| NPI | 1497358113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007642) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: IN 10003167A) | |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2023-03-15 |