| NPI | 1609148055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CO PA.0003380) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3380) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2018-10-23 |