| NPI | 1790035681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0003462) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3462) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2024-05-08 |