| NPI | 1508044066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007875) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 1685) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2023-06-30 |