| NPI | 1558923326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA1918) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PAN1918) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2022-02-17 |