| NPI | 1457654576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057502) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA-3141) |
| Enumeration Date | 2010-12-11 |
| Last Update Date | 2023-09-06 |