| NPI | 1467758557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 3368) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 014506) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2014-05-07 |