| NPI | 1114387255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115551) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1590) |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2023-08-14 |