| NPI | 1932475860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA218725) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2118) |
| 363A00000X Physician Assistant (Licence: CO PA.0006645) | |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2024-02-14 |