| NPI | 1700268786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 131031) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004294) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2021-03-16 |