| NPI | 1457634933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA2015) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015136) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2023-01-23 |