| NPI | 1336456995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA0008005) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA11859) |
| 363A00000X Physician Assistant (Licence: CO PA0008005) | |
| 363A00000X Physician Assistant (Licence: NY 014172) | |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2023-09-14 |