| NPI | 1003275611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363AM0700X Physician Assistant Medical (Licence: ME PA2341) | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2023-09-28 |