| NPI | 1992862502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0000975) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA02744) |
| 363AM0700X Physician Assistant, Medical (Licence: NM PA2015-0049) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2025-04-26 |