| NPI | 1164737110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 6384) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.0033776) |
| Enumeration Date | 2010-08-15 |
| Last Update Date | 2022-03-22 |