| NPI | 1053098418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2176) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA9493) |
| 363A00000X Physician Assistant (Licence: ME PA2682) | |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2025-06-13 |