| NPI | 1881036705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4637) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002426) |
| 363A00000X Physician Assistant (Licence: MI 5601007109) | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2019-09-25 |