| NPI | 1164728135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2579) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1246) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2024-02-15 |