| NPI | 1417144890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2011-0017) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053086) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2011-09-13 |