| NPI | 1811903768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005495) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1249) |
| 363A00000X Physician Assistant (Licence: CO 3386) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2014-10-17 |