| NPI | 1356689467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA0003722) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2015-09-23 |