| NPI | 1902278088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8604) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA1565) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2022-10-04 |