| NPI | 1568127819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007877) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114794) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2025-01-23 |