| NPI | 1215670724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2873) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 028512) |
| 363A00000X Physician Assistant (Licence: ME PA2873) | |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2025-07-02 |