| NPI | 1629520671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 4835) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004835) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2022-02-10 |