| NPI | 1710443122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005742) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005742) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2026-07-27 |