| NPI | 1801140223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 8956) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6653) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2025-05-23 |