| NPI | 1609883651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM pa2004-0023) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM PA2004-0023) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-12-26 |