| NPI | 1811130198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4012) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17874) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2023-02-23 |