| NPI | 1881010015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA.61234961) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004986) |
| 363A00000X Physician Assistant (Licence: CO PA.0004986) | |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2022-03-06 |