| NPI | 1508357112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0007755) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55732) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2024-10-08 |