| NPI | 1831355262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2013-0050) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3271) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2014-08-21 |