| NPI | 1336662212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005444) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 10424138-1206) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2018-12-02 |