| NPI | 1457632697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA0003556) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA21766) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2015-02-25 |