| NPI | 1972961266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 00000) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WY PA1187) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2025-01-07 |