| NPI | 1982662227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK PA2036) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA001178) |
| 363A00000X Physician Assistant (Licence: MO 2007028409) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-09-27 |