| NPI | 1972680585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 2431) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-03-02 |