| NPI | 1346400975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1218) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0002659) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2023-03-20 |