| NPI | 1033321278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA-130) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04735) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2019-08-09 |