| NPI | 1700038866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA4558) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA19957) |
| 363AM0700X Physician Assistant, Medical (Licence: TN PA02043) | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2021-02-19 |