| NPI | 1326706490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0007127) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 9749) |
| 363AS0400X Physician Assistant Surgical (Licence: AZ 9749) | |
| Enumeration Date | 2021-12-06 |
| Last Update Date | 2023-06-30 |