| NPI | 1619394376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004575) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51453) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2016-04-26 |