| NPI | 1245524560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 867) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA001249) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2011-06-03 |