| NPI | 1730582586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007703) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007703) |
| 363AS0400X Physician Assistant, Surgical (Licence: NV PA1755) | |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2023-05-10 |