| NPI | 1164931275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005146) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2021-01-15 |