| NPI | 1013932094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006681) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA PA10004376) |
| 363A00000X Physician Assistant (Licence: OR PA01352) | |
| 363A00000X Physician Assistant (Licence: CA 52312) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-12-15 |