| NPI | 1508295809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4031) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51296) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2018-03-17 |