| NPI | 1811327000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004106) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0945) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2022-08-19 |