| NPI | 1801087424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3267) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 3267) |
| 363AM0700X Physician Assistant, Medical (Licence: CO 3267) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 011930) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2024-10-15 |