| NPI | 1821595224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY PT752) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2020-11-25 |