| NPI | 1740971134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CO PA.0008122) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-10-23 |