| NPI | 1801454996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA100369) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 5860) |
| 363A00000X Physician Assistant (Licence: CO PA.0005860) | |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2025-05-30 |