| NPI | 1013106996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA030507) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003734) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2023-01-10 |