| NPI | 1710151162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8219) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1402) |
| 363A00000X Physician Assistant (Licence: CA 19177) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2025-07-24 |