| NPI | 1962092502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CO PA.0007702) |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2024-10-10 |