| NPI | 1952875288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007355) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ND 0010-08625) |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2022-08-02 |