| NPI | 1760931166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005263) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005263) | |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2024-08-26 |