| NPI | 1407462526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2024-0111) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT86638) |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2024-10-25 |