| NPI | 1629329487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3490) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057514) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2025-03-07 |