| NPI | 1356843940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2817) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ME AT805) |
| 363A00000X Physician Assistant (Licence: ME PA2817) | |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2025-03-05 |