| NPI | 1629752613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA224-0123) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2025-01-21 |