| NPI | 1952391435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2186) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA10005002) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2023-04-03 |