NPI | 1144633611 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA2147) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NH 1022) |
Enumeration Date | 2014-06-03 |
Last Update Date | 2023-09-18 |