| NPI | 1922467513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006561) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12056) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2023-01-04 |