| NPI | 1437765088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2806) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2465) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2024-08-02 |