| NPI | 1568928018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2107) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007130) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2022-11-07 |