| NPI | 1578534921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2087) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1322) |
| 363A00000X Physician Assistant (Licence: IA 001810) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2020-12-28 |