| NPI | 1154028066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA2577) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C08808) |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2023-11-15 |