| NPI | 1316520489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2741) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2741) |
| 363A00000X Physician Assistant (Licence: NH 1930) | |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2025-03-06 |