| NPI | 1235466673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0003623) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105221) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2013-10-22 |