| NPI | 1013061092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003959) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04935) |
| 363A00000X Physician Assistant (Licence: IN 10001283A) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2014-06-04 |