| NPI | 1629730593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1790) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA2251) |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2023-01-08 |