| NPI | 1679901540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1916) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08672) |
| 363A00000X Physician Assistant (Licence: NH 1758) | |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2022-08-23 |