| 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 |