| NPI | 1760688733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004285) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04361) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004285) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2023-08-28 |