| NPI | 1679832489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0003504) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA16810) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-09-17 |