| NPI | 1518319300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0009791) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11502) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110005427) | |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2026-06-01 |