| NPI | 1417963109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA001161) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004431) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA10004431) | |
| 363AM0700X Physician Assistant, Medical (Licence: ME PA001161) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-09-26 |