| NPI | 1275058778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2017-0052) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13616) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2025-10-13 |