| NPI | 1114441722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005075) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA198541) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005075) | |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2025-01-22 |