| NPI | 1255416772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA782) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA164) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-10-08 |