| NPI | 1992152482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA5113) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5719) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2024-01-29 |