| NPI | 1922435098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0005717) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003141) |
| 363A00000X Physician Assistant (Licence: PA MA056450) | |
| 363A00000X Physician Assistant (Licence: NY 016963) | |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2022-08-30 |