| NPI | 1154671295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004164) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 99053793A) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2020-02-07 |