| NPI | 1932105657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0004881) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002272) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2021-06-18 |