| NPI | 1134116874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 1536) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0777) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2017-04-13 |