| NPI | 1457920076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA2563) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: CO PA.0006863) | |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2022-02-11 |