| NPI | 1730496886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0002947) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002947) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2023-08-01 |