| NPI | 1003220930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004010) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60556342) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2022-02-16 |