| NPI | 1669033973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA216320) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006160) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2025-11-12 |