| NPI | 1578673067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA-2933) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 010446) |
| 363A00000X Physician Assistant (Licence: TX PA05052) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-12-30 |