| NPI | 1518910744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0003758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03078) |
| 363A00000X Physician Assistant (Licence: CA PA17976) | |
| 363A00000X Physician Assistant (Licence: IL 085001561) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2016-03-02 |