| NPI | 1891147898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2021-0090) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NM 508665563) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2024-05-08 |