| NPI | 1497793061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 814) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0633) |
| 363A00000X Physician Assistant (Licence: WA PA10004485) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2010-10-12 |