| NPI | 1902355373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006274) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3904-23) |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2022-07-28 |