| NPI | 1780061481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM PA2015-0010) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2015-0010) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2025-05-29 |