| NPI | 1811485535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007241) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021779-1) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2022-09-14 |