| NPI | 1861821837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY 585) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3738) |
| Enumeration Date | 2013-11-10 |
| Last Update Date | 2015-07-17 |