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 | 2024-09-26 |