| NPI | 1326697673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007564) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 4552) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2023-02-10 |