| NPI | 1891154407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 5481) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2016004351) |
| 363AS0400X Physician Assistant, Surgical (Licence: MO 2016004351) | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2022-01-19 |