| NPI | 1235369984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2785) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05423) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2014-10-21 |