| NPI | 1316345424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA174382) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2019-12-10 |