| NPI | 1801848874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0002983) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004567) |
| 363AS0400X Physician Assistant, Surgical (Licence: MN 10721) | |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA10004567) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-11-13 |