| NPI | 1073841466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7155) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0008104) |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2023-08-22 |