| NPI | 1083929889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 3435) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105491) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2012-07-05 |