| NPI | 1598385684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006872) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA 324417) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2022-03-02 |