| NPI | 1396023727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2017-0022) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017629) |
| 363A00000X Physician Assistant (Licence: ME PA001284) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2017-12-21 |