| NPI | 1912378274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008178) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 300207) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2023-12-05 |