| NPI | 1568999415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2017-0048) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM 1143587) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-01-24 |