| NPI | 1760700397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM PA2010-0033) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2010-0033) |
| 363AS0400X Physician Assistant, Surgical (Licence: NM PA2010-0033) | |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2023-07-06 |