| NPI | 1316201932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4424) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA23226) |
| 363A00000X Physician Assistant (Licence: ME PA1611) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2024-02-11 |