| NPI | 1235157488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2003) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 103723) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-01-30 |