| NPI | 1861626228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004918) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52979) |
| 363A00000X Physician Assistant (Licence: CO 4918) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2024-03-15 |