| NPI | 1144626789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2020-0070) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-004701) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2021-11-17 |