| NPI | 1528244894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD CO4459) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA18732) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2017-10-31 |