| NPI | 1881020287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1721) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: NY 016930) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2022-07-21 |