| NPI | 1528587987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA2305) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60863588) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2022-04-06 |