| NPI | 1487152948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA188460) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005178) |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2021-12-01 |