| NPI | 1952066037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 005370) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5370) |
| 363A00000X Physician Assistant (Licence: CO PA.0008577) | |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008577) | |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2024-08-14 |