| NPI | 1659562445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3133) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60064017) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2022-02-11 |