| NPI | 1578194585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 67031) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2030) |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2025-11-11 |