| NPI | 1164890372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9543) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004487) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2023-02-06 |