| NPI | 1720516834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 006757) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2252) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2024-09-24 |