| NPI | 1518632132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008738) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10589) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2024-09-16 |