| NPI | 1588635478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NM PA2004-0014) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9110347) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2018-01-26 |