| NPI | 1891041810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006960) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004907) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2022-01-24 |