| NPI | 1780676866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA-059) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2004-0017) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2010-11-05 |