| NPI | 1639701030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 0008834) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA14357) |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2025-01-21 |