| NPI | 1407232028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006189) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12675) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05769) | |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2022-04-20 |