| NPI | 1548245020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA0002992) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10000620A) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2021-06-16 |