| NPI | 1366630519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009009) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA0003501) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003501) | |
| 207R00000X Internal Medicine (Licence: VA 0110009009) | |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2023-03-01 |