| NPI | 1467452185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002587) |
| 363A00000X Physician Assistant (Licence: PA MA003586L) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2021-06-25 |