| NPI | 1194730663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2004-0055) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM PA2004-0055) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2021-11-23 |