| NPI | 1205436011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2112) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH EL31989) |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2025-01-14 |