| NPI | 1528463056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 10376872-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004263) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA057248) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004263) | |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2021-10-16 |