| NPI | 1295293918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2249) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07251) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2021-11-12 |