| NPI | 1689927832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003463) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10175) |
| 363A00000X Physician Assistant (Licence: CO 3463) | |
| 363A00000X Physician Assistant (Licence: MD C0004974) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2018-11-30 |