| NPI | 1316502743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2021-0046) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58631) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2023-07-18 |