| NPI | 1649512534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-003746) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2016-03-23 |