| NPI | 1891150108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2015-0082) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NM 1130229) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2016-07-20 |