| NPI | 1366802035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NM PA2021-104) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO PA.0004560) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2022-02-03 |