| NPI | 1760833388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2016-0067) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2022-03-07 |