| NPI | 1023331592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2769) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50002682) |
| 363A00000X Physician Assistant (Licence: IN 10002536A) | |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2025-01-21 |