| NPI | 1922132141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03952) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005276) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2019-06-24 |