| NPI | 1902305741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006012) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA11773) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2020-01-30 |