| NPI | 1326396235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005851) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60790428) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2019-08-29 |