| NPI | 1164416103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PAN2017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME PAN2017) |
| 207R00000X Internal Medicine (Licence: NH 0481P) | |
| 363A00000X Physician Assistant (Licence: NH 0481P) | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2020-01-22 |