| NPI | 1235410515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA1775) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2012-0052) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2021-06-09 |