| NPI | 1245670736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-49941) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3719) |
| 363A00000X Physician Assistant (Licence: WA PA60610762) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2021-08-04 |