| NPI | 1881976868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 5356) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 015077) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2019-01-28 |