| NPI | 1215405733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2199) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1450) |
| 363A00000X Physician Assistant (Licence: ME PA2199) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2024-08-19 |