| NPI | 1972013613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2350) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1311) |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2022-06-28 |