| NPI | 1851521389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0003615) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI 5601005548) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2024-07-17 |