| NPI | 1255976510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2019-0094) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM PA2019-0094) |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2021-10-28 |