| NPI | 1184154031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006196) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3881) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2020-08-31 |