| NPI | 1437450996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004954) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004954) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105670) | |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2020-05-21 |