| NPI | 1588117881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2022-0017) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1632) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2023-07-21 |