| NPI | 1619297959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109458) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA001212) |
| 363A00000X Physician Assistant (Licence: NM PA2014-0042) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2024-05-17 |