| NPI | 1700335833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 9532) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005684) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2023-03-17 |