| NPI | 1750864773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005563) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55972) |
| 363A00000X Physician Assistant (Licence: NC 0010-09673) | |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2024-11-04 |