| NPI | 1609299213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5561) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1426) |
| 363A00000X Physician Assistant (Licence: NH 3681) | |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2026-06-30 |