| NPI | 1992232243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA207444) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005066) |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2023-06-09 |