| NPI | 1427605682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2023-0235) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 324685) |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2023-08-09 |