| NPI | 1801415773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2020-0076) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2023-09-14 |