| NPI | 1154084507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA3084) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA3084) |
| 363A00000X Physician Assistant (Licence: MA PA8392) | |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2026-07-06 |