| NPI | 1649417841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0002624) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60687147) |
| Enumeration Date | 2009-01-10 |
| Last Update Date | 2020-03-18 |