| NPI | 1679933972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1939) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1584) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2022-11-17 |