| NPI | 1356643985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2017-0025) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014502) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2023-11-30 |