| NPI | 1922382662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005611) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106098) |
| 363A00000X Physician Assistant (Licence: CA PA51294) | |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2019-09-27 |