| NPI | 1871089235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006039) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-08157) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2019-11-12 |