| NPI | 1851863419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2021-0042) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-879) |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2023-09-27 |