| NPI | 1194117713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004588) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 7486) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO 4588) | |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2023-06-02 |