| NPI | 1538526512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA007604) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC PA2499) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2025-01-29 |