| NPI | 1396134300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA173091) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004161) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2020-08-06 |