| NPI | 1780093641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004891) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017831) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2019-07-31 |