| NPI | 1174707020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA720) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006650) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2023-08-23 |