| NPI | 1497302335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006723) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12896) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2021-09-22 |