| NPI | 1154745321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004939) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004939) |
| 363A00000X Physician Assistant (Licence: CA 51440) | |
| Enumeration Date | 2014-02-09 |
| Last Update Date | 2024-04-29 |