| NPI | 1750789723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 2471582) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2014-0088) |
| 363A00000X Physician Assistant (Licence: NM PA2014-0088) | |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2025-11-14 |