| NPI | 1174684369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2006-0050) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2006-0050) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2023-04-21 |