| NPI | 1972963668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 6426) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006023) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2022-03-22 |