| NPI | 1184602823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA0004483) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110001693) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2016-08-12 |