| NPI | 1629692108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: CO ANT.0000136) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: MO 2020014589) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-11-04 |