| NPI | 1770004244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2408) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004984) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2024-03-05 |