| NPI | 1710506878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.9672) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115212) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2026-07-10 |