| NPI | 1962633800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0003705) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0003705) |
| 363A00000X Physician Assistant (Licence: ME PA001173) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2026-01-23 |