| NPI | 1821357369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005682) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22253) |
| 363A00000X Physician Assistant (Licence: VT 055.0031151) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA22253) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2019-03-01 |