| NPI | 1396133799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005653) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA0004162) |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2016-02-03 |