| NPI | 1710307939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0005698) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00332800) |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2025-01-28 |