| NPI | 1346631637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CO 0004221) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO 0004221) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2025-02-04 |