| NPI | 1619220746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 5028) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03682) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2024-11-25 |