| NPI | 1639652241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2181) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060065) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2021-05-11 |