| NPI | 1730365461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007941) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9474) |
| 363A00000X Physician Assistant (Licence: FL PA9106045) | |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2024-01-16 |