| NPI | 1528583267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2241) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6178) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2025-02-03 |