| NPI | 1043959224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008079) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 9271) |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2023-11-28 |