| NPI | 1457464950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 2617) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0002866) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110002237) | |
| 363AM0700X Physician Assistant, Medical (Licence: DC PA030428) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2009-05-20 |