| NPI | 1508364068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007630) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3470) |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2023-07-14 |