| NPI | 1588840698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2018-0063) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA05858) |
| 363A00000X Physician Assistant (Licence: IL 085004936) | |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2020-03-12 |