| NPI | 1831540434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006378) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2020-12-01 |