| NPI | 1740656172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6473) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 4314) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2016-12-22 |