| NPI | 1538499397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004335) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054126) |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2024-03-28 |