| NPI | 1316303720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007603) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058061) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00388800) | |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2022-11-11 |