| NPI | 1568079283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007412) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007412) |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2022-09-01 |