| NPI | 1548652530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2023-0245) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09760) |
| 363A00000X Physician Assistant (Licence: MS PA00232) | |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2023-10-30 |