| NPI | 1669413340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA-504) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA171057) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2025-09-15 |