| NPI | 1043564941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006497) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007438) |
| 363A00000X Physician Assistant (Licence: CO PA.0007438) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2023-09-20 |