| NPI | 1730198391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006334) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2010-0001) |
| 363AS0400X Physician Assistant, Surgical (Licence: OK 2162) | |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 8449) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006334) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2025-02-28 |