| NPI | 1639596018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2399) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NH 1669) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2022-11-10 |