| NPI | 1275981250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005188) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2016-0045) |
| 363AS0400X Physician Assistant, Surgical (Licence: NM PA2016-0045) | |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2023-06-13 |