| NPI | 1801997226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4185) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 2181) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2016-08-08 |