| NPI | 1376093229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2574) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058538) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2024-08-23 |