| NPI | 1134522063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2568) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108090) |
| 363A00000X Physician Assistant (Licence: NM PA2014-0081) | |
| 363A00000X Physician Assistant (Licence: WA PA61220081) | |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2025-02-27 |