| NPI | 1649279266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2009-043) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 2822) |
| 363AM0700X Physician Assistant, Medical (Licence: MT 566) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 005692-1) | |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2013-06-17 |