| NPI | 1881668044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2413) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 103872) |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110003413) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2014-08-28 |