| NPI | 1982089108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4336) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004336) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2026-09-25 |