| NPI | 1568128056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008286) |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2025-02-24 |