| NPI | 1598305989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2020-0049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110010777) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2025-07-22 |