| NPI | 1689924698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2019-0018) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AK 1068) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2022-04-08 |