| NPI | 1184731770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AM0700X Physician Assistant, Medical (Licence: NM PA2006 0028) | |
| 363AM0700X Physician Assistant, Medical (Licence: NM PA2006-0028) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2018-06-16 |