| NPI | 1407285711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY PA684) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA0003858) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2024-12-31 |