| NPI | 1336631498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CO PA.0006576) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031598) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2022-09-01 |