| NPI | 1952716250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12103) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1562) |
| 363A00000X Physician Assistant (Licence: VA 0110004638) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2022-04-29 |