| NPI | 1033991591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: ME PA2815) | |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2025-05-12 |