| NPI | 1598895344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2187) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY PT935) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2021-07-27 |