| NPI | 1790411528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12451) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 0010-12451) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0009077) | |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2025-11-10 |