| NPI | 1275666737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME175325) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL pa9103057) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2025-09-24 |