| NPI | 1588332399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007982) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 11018) |
| Enumeration Date | 2021-09-06 |
| Last Update Date | 2025-06-06 |