| NPI | 1255531356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2022-0076) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA 9107535) |
| 363AM0700X Physician Assistant Medical (Licence: WV 1076461) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2022-12-28 |