| NPI | 1073396305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2025-0058) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2025-06-26 |