| NPI | 1770590952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 9689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0775) |
| 363A00000X Physician Assistant (Licence: ME PA-658) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-12-01 |