| NPI | 1396943395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07913) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO PA.0002664) |
| 363A00000X Physician Assistant (Licence: CO PA.0002664) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2022-05-12 |