| NPI | 1831546217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2298) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA183691) |
| 363AS0400X Physician Assistant, Surgical (Licence: OR PA183691) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2022-07-22 |