| NPI | 1235578477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA0006021) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 4690-23) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 1110395) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2021-05-04 |