| NPI | 1851572655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2010-0040) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012262-1) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2011-01-11 |