| NPI | 1851630776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 0003877) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006726) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2019-01-02 |