| NPI | 1568614279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003269) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012868) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2018-03-17 |