| NPI | 1699243915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2018-0092) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0008548) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2024-10-22 |