| NPI | 1578956538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1479) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1929) |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2021-03-30 |