| NPI | 1528850302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0009875) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 23.007111) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2026-09-01 |