| NPI | 1770935348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005327) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005327) |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110-005411) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2019-10-16 |