| NPI | 1699158477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 004298) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01897) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2019-07-24 |