| NPI | 1265711279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2248) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00733) |
| 363A00000X Physician Assistant (Licence: CA PA21741) | |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2021-10-25 |