| NPI | 1588139349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007766) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL 1342) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2024-08-15 |