| NPI | 1538466990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 4049) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085003849) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2015-07-08 |