| NPI | 1821410101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 5218) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005218) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2019-04-23 |