| NPI | 1720611544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2023-0035) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2024-01-03 |