| NPI | 1023649449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM PA2020-0017) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-26 |