| NPI | 1811012602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM 81-PA016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 81-PA016) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2009-07-23 |