| NPI | 1053355263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 1799) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO 1799) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2014-02-07 |