| NPI | 1093982829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA1867) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9103602) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2018-12-06 |