| NPI | 1275601734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2611) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001865) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 001865) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2025-12-18 |