| NPI | 1124275193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014625) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA001136) |
| 363A00000X Physician Assistant (Licence: PA MA053934) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2015-12-16 |