| NPI | 1912599572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA62518) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007063) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2023-03-22 |