| NPI | 1376552281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004488) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9101925) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9101925) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2019-02-05 |