| NPI | 1730119058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: ME PA1056) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1056) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2022-03-03 |