| NPI | 1407822315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007312) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 1492) |
| 363A00000X Physician Assistant (Licence: TX PA12235) | |
| 363AM0700X Physician Assistant, Medical (Licence: OK 1492) | |
| 363AS0400X Physician Assistant, Surgical (Licence: OK 1492) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2022-07-18 |