| NPI | 1093730350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114790) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: ME PA001049) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106619) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-04-06 |