| NPI | 1336201136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2004-0032) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2004-0032) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2016-04-15 |