| NPI | 1194293738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007138) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA6681) |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2022-03-16 |