| NPI | 1023436367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1016) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2237) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-08-23 |