| NPI | 1114243979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3080) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20218) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2012-09-10 |