| NPI | 1316136351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CO PA0004582) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TX PA05445) |
| 363AS0400X Physician Assistant Surgical (Licence: TX PA05445) | |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2025-08-15 |