| NPI | 1992777130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2003-003) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2003-0031) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2021-05-05 |