| NPI | 1356685747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 0003597) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 8476110-1206) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2021-05-04 |