| NPI | 1750702981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007151) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 1113507) |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2024-06-11 |