| NPI | 1245487768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 107256) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD CO3838) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2022-09-23 |