| NPI | 1871265090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2023-0214) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 66726) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2025-10-03 |