| NPI | 1699928184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 2702) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 002713) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2013-09-23 |