| NPI | 1417061821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO 2178) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CO 2178) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2018-06-06 |