| NPI | 1700849205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 101809) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: ME PA2664) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2024-06-14 |