| NPI | 1316445497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007467) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0964) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA9112175) | |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2023-10-04 |