| NPI | 1801883525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0002234) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NE 1001) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2021-10-18 |