| NPI | 1376689745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2007-0001) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 104148) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2017-03-22 |