| NPI | 1609281864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005355) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C05425) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2019-07-30 |