| NPI | 1134604978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2018-0074) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NM PA2018-0074) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-12-17 |