| NPI | 1740152115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA2953) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110011349) |
| Enumeration Date | 2025-09-23 |
| Last Update Date | 2025-10-24 |