| NPI | 1275966376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005794) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004317) |
| 363A00000X Physician Assistant (Licence: DC PA031197) | |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2023-01-28 |