| NPI | 1093269623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY PA835) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA0004732) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2020-04-23 |