| NPI | 1659476398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2021-0130) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 988) |
| 363A00000X Physician Assistant (Licence: CO PA.005343) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-05-07 |