| NPI | 1508151606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 5385) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NM PA-091) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2014-01-31 |