| NPI | 1952450355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CO 2042) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| 363A00000X Physician Assistant (Licence: CO 2042) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2024-02-09 |