| NPI | 1750510533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0734) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1660) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2021-03-04 |