| NPI | 1619304359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 3729) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018940) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2018-07-11 |