| NPI | 1073601050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0001558) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CO 1558) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2022-01-24 |