| NPI | 1225764350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM pa2024-0076) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: MN 10808090) |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2025-05-08 |