| NPI | 1710521950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1846) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA1998) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2022-04-28 |