| NPI | 1578938890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 5382) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6277) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2020-08-28 |