| NPI | 1063989176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA2290) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 7295) |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2022-02-11 |