| NPI | 1487209904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2024-0141) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13900) |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2025-01-06 |