| NPI | 1851355382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2016-0065) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA3110) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2016-10-26 |