| NPI | 1255418034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 753) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA-2663) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-01-27 |