| NPI | 1487319364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008109) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0008182) |
| 363A00000X Physician Assistant (Licence: CO PA.0008109) | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2024-02-13 |