| NPI | 1780872978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006406) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004537) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2022-12-16 |