| NPI | 1205124005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA1283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1283) |
| 363AS0400X Physician Assistant, Surgical (Licence: ME PA001283) | |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2022-02-17 |