| NPI | 1043216179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2016-0057) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA04560) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2024-05-07 |