| NPI | 1962979690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62119) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022945) |
| 363A00000X Physician Assistant (Licence: CO PA.0007797) | |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2024-09-13 |