| NPI | 1578674354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PZ2016-0037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA-827) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-02-21 |