| NPI | 1417228990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL 810) |
| Enumeration Date | 2012-01-16 |
| Last Update Date | 2013-10-18 |