| NPI | 1225334766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006588) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00449400) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA054798) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2024-08-14 |