| NPI | 1871820183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2081) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054151) |
| 363A00000X Physician Assistant (Licence: ME PA1387) | |
| 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000691) | |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2023-08-31 |