| NPI | 1528725033 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2021-0109)  | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2021-11-18 | 
| Last Update Date | 2023-06-08 |