| NPI | 1649765595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007107) |
| 363A00000X Physician Assistant (Licence: CO PA.0007107) | |
| Enumeration Date | 2018-06-23 |
| Last Update Date | 2023-12-15 |