| NPI | 1750944765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2019-0051) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026412) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2024-09-23 |