| NPI | 1689155665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007936) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007076) |
| 363A00000X Physician Assistant (Licence: IN 10002548A) | |
| 363A00000X Physician Assistant (Licence: CO PA.0007936) | |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2023-08-11 |