| NPI | 1548457997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2007-0025) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA20070025) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2021-08-31 |