| NPI | 1487163929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2024-0128) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL F263-1129-7639) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2026-07-28 |