| NPI | 1124112701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA228) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA228) |
| 363AS0400X Physician Assistant, Surgical (Licence: ME PA-186) | |
| 363A00000X Physician Assistant (Licence: ME PA-186) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-06-03 |