| NPI | 1700106218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2018-0040) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA06228) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005385) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2019-06-25 |