| NPI | 1184294332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0009618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5233) |
| 363AS0400X Physician Assistant, Surgical (Licence: TN 5233) | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2026-07-31 |