| NPI | 1568287357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0009015) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2025-02-05 |