| NPI | 1972768620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0002625) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA-2625) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2026-03-06 |