| NPI | 1841847514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA2159) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 023880) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2021-02-11 |