| NPI | 1295287043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12209) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA1673) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2024-06-13 |