| NPI | 1215120530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2012-0060) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC A934) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2015-08-19 |