| NPI | 1972162436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 7500) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2023-05-18 |