| NPI | 1962596338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NM PA2003-0029) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM PA2003-0029) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-07-21 |