| NPI | 1720408172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004662) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60610430) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2024-07-22 |