| NPI | 1235102336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0457 P) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2021-06-07 |