| NPI | 1548563976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2809) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3110) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2017-12-26 |