| NPI | 1952593584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2018-0041) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2449) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2026-08-28 |