| NPI | 1346326329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2011-0054) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051235) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-03-02 |