| NPI | 1972167377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2108) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 3553) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2025-10-22 |