| NPI | 1598158826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0007555) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5939) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2025-03-12 |