| NPI | 1558827592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0009302) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112012) |
| 363A00000X Physician Assistant (Licence: AL PA.2221) | |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2025-09-06 |