| NPI | 1912184557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01324) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1307) |
| 363A00000X Physician Assistant (Licence: OH 50.005749RX) | |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2023-08-16 |