| NPI | 1891565594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CO PA.0008173) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO PA.0008173) |
| 363A00000X Physician Assistant (Licence: CO PA.0008173) | |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-10-09 |