| NPI | 1679949648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 4856) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IA 079192) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2020-03-24 |