| NPI | 1497164321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3993) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031079) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2018-06-01 |