| NPI | 1003189069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2012-0009) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: NM PA2012-0009) | |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2023-04-26 |