| NPI | 1992767677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM NM2000PA29) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 59060) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2024-02-28 |