| NPI | 1598321457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2458) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12988) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2023-02-06 |