| NPI | 1225279607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 0004754) |
| 363A00000X Physician Assistant (Licence: AK 1185) | |
| 363A00000X Physician Assistant (Licence: NC 0010-01762) | |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2024-06-05 |