| NPI | 1518591759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006494) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.007543) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-12-01 |