| NPI | 1073560272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06505) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA-664) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2023-09-07 |