| NPI | 1720583511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2479) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-10-25 |