| NPI | 1497128235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.005450) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115779) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085.005515) | |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2024-04-02 |