| NPI | 1558435222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004653) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2009-0011) |
| 363AS0400X Physician Assistant, Surgical (Licence: NM PA2009-0011) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2024-08-12 |