| NPI | 1215121587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA6132) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0961) |
| 363A00000X Physician Assistant (Licence: ME PA001106) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2023-08-08 |