| NPI | 1518051663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 111580) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-002015) |
| 363A00000X Physician Assistant (Licence: ME PA-254) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-12-29 |