| NPI | 1760723522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2388) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60325568) |
| 363A00000X Physician Assistant (Licence: CO PA0005373) | |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2019-08-08 |