| NPI | 1609104629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0009266) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 7492194-1206) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2025-09-09 |