| NPI | 1356621643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 127937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA-3281) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2021-03-26 |