| NPI | 1295709541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 4026) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 1893) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2021-12-06 |