| NPI | 1265806905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005804) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2477) |
| 363AM0700X Physician Assistant, Medical (Licence: LA 305484) | |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2019-08-16 |