| NPI | 1760434575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4369) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 3256) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-02-09 |