| NPI | 1023445657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11174) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005378) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 5516) | |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2022-09-19 |