| NPI | 1851556120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1398) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1398) |
| 363AM0700X Physician Assistant, Medical (Licence: CO 3599) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2018-09-06 |