| NPI | 1336566868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0003921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0003921) |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2020-08-23 |