| NPI | 1821643123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007374) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007199) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2022-08-25 |