| NPI | 1376978031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CO SA.0002231) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other Surgical Technologist |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2024-05-09 |