| NPI | 1992137939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4755) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2022-0091) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2023-09-11 |