| NPI | 1043419021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA744) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: HI AMD248) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2019-09-24 |