NPI | 1093190969 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2022-0102) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05917) |
Enumeration Date | 2015-07-21 |
Last Update Date | 2023-02-16 |