| NPI | 1487134284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2071) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA6708) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2020-07-02 |