| NPI | 1518232578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2023-0272) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA PA200527) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2025-07-30 |