| NPI | 1437149820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 335815-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 680) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO 680) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2024-11-07 |