| NPI | 1073823944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004614) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.004614) |
| 363A00000X Physician Assistant (Licence: IL 085.003923) | |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004614) | |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2024-03-07 |