| NPI | 1932628450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA2311) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA059270) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2022-05-24 |