| NPI | 1093118960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1612) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5185) |
| 363A00000X Physician Assistant (Licence: MI 5601007747) | |
| 363A00000X Physician Assistant (Licence: ME PA2354) | |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2022-06-16 |