| NPI | 1750949855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0005648) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0773) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2024-03-28 |