| NPI | 1104051960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004398) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA-082) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2016-04-19 |