| NPI | 1649821083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008439) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3995) |
| 363A00000X Physician Assistant (Licence: CO PA.0008439) | |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2024-04-23 |