| NPI | 1518570738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2784) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA201539) |
| 363A00000X Physician Assistant (Licence: ME PA2784) | |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2025-01-21 |