| NPI | 1669889879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008756) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3199) |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA09951) | |
| Enumeration Date | 2014-07-20 |
| Last Update Date | 2025-05-12 |