| NPI | 1871168724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007921) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MA PA8146) | |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2023-09-18 |