| NPI | 1497264246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA57225) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007622) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007622) | |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2023-03-10 |