| NPI | 1568767267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2011-0004) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9105626) |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2016-06-08 |