| NPI | 1023774106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2023-0248) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0007146) |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2023-09-07 |