| NPI | 1801477039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9735) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO PA.0006866) |
| 363A00000X Physician Assistant (Licence: CO PA.0006866) | |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2023-07-31 |