| NPI | 1861670531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003882) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06481) |
| 363AS0400X Physician Assistant Surgical (Licence: CO PA 0003882) | |
| 363AS0400X Physician Assistant Surgical (Licence: NC 001001240) | |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2021-10-05 |