| NPI | 1558733493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 239153) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006063) |
| 363AM0700X Physician Assistant, Medical (Licence: MA PA8212) | |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2025-10-01 |