| NPI | 1972754885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006118) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NE 1738) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2021-12-08 |