| NPI | 1568834513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0001026) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005046) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA057906) | |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2018-03-13 |