| NPI | 1952886830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 11332) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA1866) |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2023-01-11 |