| NPI | 1669929063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2017-0102) |
| 363A00000X Physician Assistant (Licence: AZ 6501) | |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2022-02-23 |