| NPI | 1952899908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006217) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12765) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2022-04-18 |