| NPI | 1679098099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005926) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2017-0056) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2022-07-21 |