| NPI | 1093967606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 1338) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2019-07-29 |